Q.
Has there ever been a study on why people undergo body modifications such as body piercing, tattooing, branding, etc? Is it an expression of feelings, such as pain and suffering, that they can't or don't know how to communicate in any other way? Or is it simply a desire to adorn oneself?

A.
I think that the underlying feelings and motives differ widely from person to person, and culture to culture. But when body-piercing or tattooing reaches an extreme, I believe there is usually some underlying psychopathology. In terms of research, there was an interesting study of differences in self-concept and behavior between college students involved in tattooing/body piercing (TBP) and those who were not (Drewes et al, Psychol Rep 2000 86:475-81). Tattooed students rated themselves as more adventurous, creative, artistic, individualistic, and risky than those without tattoos.

Males with tattoos reported smoking more cigarettes, having more sexual partners, and more arrests than non-tattooed males. Tattoed women were more likely to report use of drugs, shoplifting, and body piercing in places other than their ears. Taken together, these data suggest that TBP may be associated with a greater need to engage in risky behaviors than seen in non-TBP individuals. Perhaps it also indicates a tendency toward sociopathic behavior (violating societal social and legal norms). Some clinicians believe that TBP exists on a continuum that includes more severe forms of bodily mutilation and self-injurious behavior (SIB). Favazza et al (J Nerv Ment Dis 1998 186:259-68) state that self-mutilation "...can best be understood as a morbid self-help effort, providing rapid but temporary relief from feelings of depersonalization, guilt, rejection and boredom, as well as hallucinations, sexual preoccupations, and chaotic thoughts."

On the other hand, a teenager who comes home with a tattoo on her cheek, after a weekend in New York City with a group of friends, may be acting out of normal adolescent feelings--that is, wanting to belong, fit in, and raise a little hell for the benefit of her parents!